Outline

Objective

To evaluate the short-term effectiveness of transpalpebral orbital lipectomy at the Department of Ohthalmology University of Debrecen, Hungary.

Methods

Using a transpalpebral approach, connective tissue and fat were removed from 50 orbits of 33 patients (25 female, 8 male), over a 5 year period. The amount of tissue removed from the orbit was between 2.0-6.5 cm3. The patients (age 18-67 years) had suffered from Graves' orbitopathy for between 2-22 years; disease severity ranged from mild to severe. Indications for the surgery were cosmetic correction of exophthalmos in 27 patients with mild visual deterioration, severe acute complications leading to corneal damage in 5 patients, and in 1 patient to arrest rapid (within a few days) bilateral deterioration of visual acuity.

Results

In the 27 cases of correction for aesthetic purposes, there was no change in visual acuity after surgery. In the patients with corneal complications, symptoms and signs improved after lipectomy. In 13 cases the previously high intraocular pressure decreased after the operation, and in 8 of these returned to normal. Of the 13 patients with piplopia in 7 cases the diplopia diminished, in 2 it did not change, and in 4 cases it worsened (in 2 cases only temporarily, in 2 cases permanently). In the patient with progressive deterioration of visual acuity, values for both eyes returned to near normal. On follow-up examination at the end of the third postoperative month, the average decrease in ocular protrusion for all patients was 3 mm.

Conclusions

Transpalpebral orbital lipectomy is a low risk, highly effective technique for orbital decompression in both acute and chronic cases of Graves' orbitopathy.